Placenta Accreta, Increta & Percreta

Placenta accreta, increta and percreta result from inappropriate placental attachments.  In placenta acreta, the placenta attaches too firmly and deeply into the uterine wall.  In placenta increta, the attachment is much deeper into the wall, preventing easy separation after birth.  In placenta percreta, the placenta attaches right through or beyond the uterus, invading sometimes to other internal organs, most commonly the bladder.

Symptoms

In all cases, symptoms are similar to those of placenta previa and placental abruption, including late term vaginal bleeding and preterm delivery of the baby. 

Complications

The largest complication of these conditions is that the placenta does not readily detach from the uterine wall and will usually require surgical removal.  This can lead to no other choice than hysterectomy, although increasingly other procedures are attempted to prevent the removal of the uterus. 

Rates of Occurence

These placental complications occur in about 1 of 2,500 pregnancies.

Can I STILL have a natural birth?

This will depend on many factors, including the severity, gestational age, and severity of the disorder.  In many cases, a c-section will be scheduled in an attempt to preserve the mother's future fertility, in which case a c-cesarean is a small price to pay for the ability to have more children in the future.

References

Carroli G, Bergel E. Umbilical vein injection for management of retained placenta. Cochrane Database of Systematic Reviews 2001, Issue 4. Art. No.: CD001337. DOI: 10.1002/14651858.CD001337.

Peña-Martí G, Comunián-Carrasco G. Fundal pressure versus controlled cord traction as part of the active management of the third stage of labour. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD005462. DOI: 10.1002/14651858.CD005462.pub2.

Prendiville WJ, Elbourne D, McDonald S. Active versus expectant management in the third stage of labour. Cochrane Database of Systematic Reviews 2000, Issue 3. Art. No.: CD000007. DOI: 10.1002/14651858.CD000007.

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Page Last Modified by Catherine Beier, MS, CBE